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Psychological Toolkit to manage distress during COVID-19

 

 

Further to my earlier post about offering a psychological toolkit for managing the emotional difficulties during COVID-19, especially for those who suffer from challenges with regards to trauma and attachment or complex trauma/Complex PTSD, I have created the following document.

 

Please note, that I will keep adding to this list, so it will be expanding. Feel free to come back from time-to-time for any updates.

 

Disclaimer: Some of the strategies here are based on my professional experiences, training, skills and knowledge. Others are what I have learned from resources created by other clinicians/trauma therapists, and I cannot take any credit for those.

 

Support Forums and Facebook Support Groups

To those in need:

 

There are two types of trauma survivors when it comes to asking for help (generally the survivors fall into these two categories of survival/coping strategies):

 

• Those who do not ask for help/those who avoid asking for help from others
• Those who constantly depend on help from others (co-dependence)

 

Many CPTSD survivors did not have support throughout their life and had to rely on themselves their whole life – so what should be normal and comfortable, such as seeking help and support from others, and admitting that you are struggling, does not usually come natural to you, and it can be an uncomfortable experience. Often you feel like being weak or a burden whenever expressing what is a normal human need for connection, nurture and reassurance. You deserve support, help, nurture and connection. It is ok to reach out for support, and it is OK to accept help. You don’t deserve it any less than others. 

 

Remember that if you are brave enough to post something in a support group/support forum as a way of reaching out for help, and then if someone respond in a way that is feeling unsupportive/critical/harsh/judgemental to you, take a moment away from the group and follow the 13 steps by Pete Walker listed below. Remember it is probably their way of showing that they are having a hard time and struggling to cope, and this is the only way they know how to show it at that moment in time, and it is NOT a reflection of you and what you deserve. Then when you are ready, you can go back to the forum/group and focus on the supportive and empathic responses.

 

In the unfortunate circumstance where nobody respond to your post, it can truly feel like a rejection, and trigger all the feelings of not being valued, not being cared about and feeling unimportant and unloved. It can trigger sense of abandonment. Many of the members in the support groups and forums will be struggling themselves and in need of help and support. Otherwise, they won’t be in a support group. They will be going through a tough time (similar to yourself and in crisis etc). So as part of selfcare they might have scrolled past your post in order to look after themselves and ensuring they don’t get triggered etc. I know that when I’m struggling and in crisis, I prioritise on using the small bit of energy I have left towards my own selfcare rather than using it on being there for others. This is usually the reason rather than people intentionally ignoring your post/not responding to you. I hope that externalising the situation (thinking of what the external factors could be) than internalising it (taking it personally) will be helpful to you.

 

To those wishing to support someone in need:

 

Often those who have survived trauma struggle to do what others might take for granted, what others might not even think twice about can often be a huge ordeal for people who have experienced complex trauma.  For example, when a trauma survivor opens up and seeks help, it can put themselves in a vulnerable position (probably being extremely brave facing one of their biggest fears: Showing that they feel vulnerable and admitting to you that they are struggling/in crisis, and need help). Before posting/commenting/saying anything to them, pause for a moment to consider whether what you are going to say could be helpful to someone who might not openly admit that they are struggling and in crisis. Before posting, perhaps ask yourself if your comment is kind, compassionate and supportive – and most importantly, if what you were thinking of saying is going to be empathic and nurturing to someone who is feeling vulnerable, in a dark place/triggered place, struggling and in crisis mode?

 

To someone who might be feeling very vulnerable, alone and unsupported (which is often a huge trigger for most CPTSD survivors due to their trauma being relational), your comment (if being unsupportive/critical/harsh/judgemental) could  make someone leave a support group because it triggers them into feeling abandoned, weak and alone. Or it could trigger them to go on a down-ward spiral , struggling even more. If you are not in a place to offer support , that’s fine, we all have moments like that, then scroll past, don’t say anything.
13 steps for reducing distress by Pete Walker (Copyright by Peter Walker)

 

The list of the following 13 steps have been recommended by the well-known trauma therapist, Pete Walker, to use when you are in immediate distress to reduce fear and anxiety. This resource is from his book called, ‘Complex PTSD: From Surviving to Thriving’. Although, it is specifically written with Complex Trauma survivors in mind, the strategies can be used by anyone suffering from anxiety or distress.

 

The 13 strategies are practical steps for helping yourself to manage an emotional flashback. Emotional flashback can feel a little bit like a panic attack but much more intense and people often describe them as, or confuse them to triggers. Pete Walker describes emotional flashback as an intense, confusing and disturbing phenomenon. It can be accompanied by an intense arousal of the flight/fight instinct. Some signs are that you feel extremely anxious, panicky, or even suicidal. For others, it can be characterised by a sense of numbness, feeling ‘flat’, paralysed and wanting to hide away. For some, it can be a sense of feeling small, fragile, powerless and helpless. Sometimes, it can be a combination of all, or some of these feelings.

 

I hope the list below will be helpful to you (FOCUS ON THE BOLD PRINT WHEN FLASHBACK IS ACTIVE):

  1. Say to yourself: “I am having a flashback”. Flashbacks take you into a timeless part of the psyche that feels as helpless, hopeless and surrounded by danger as you were in your childhood. The feelings and sensations you are experiencing are past memories tat cannot hurt you now.

  2. Remind yourself: “I feel afraid but I am not in danger! I am safe now, here in the present.” Remember you are now in the safety of the present, far from the danger of the past.

  3. Own your right/need to have boundaries. Remind yourself that you do not have to allow anyone to mistreat you; you are free to leave dangerous situations and protest unfair behaviour.

  4. Speak reassuringly to the Inner Child. The child needs to know that you love her/him unconditionally – s/he can come to you for comfort and protection when s/he feels lost and scared.

  5. Deconstruct eternity thinking. In childhood, fear and abandonment felt endlessly – a safer future was unimaginable. Remember this flashback will pass as it always has before.

  6. Remind that you are in an adult body with allies, skills and resources to protect you that you never had as a child. [Feeling small and fragile is a sign of an emotional flashback.]

  7. Ease back into your body. Fear launches you into “heady” worrying, numbing and spacing out     [a] Gently ask your body to Relax: feel each of your major muscle groups and softly encourage them to relax. [Tighten muscles send false danger signals to your brain.]                                               [b] Breathe deeply and slowly. [Holding your breath also signals danger.]                                           [c] Slow down: rushing presses your brain’s flight response button.                                                     [d] Find a safe place (Pete Walker has called this a ‘safe place’. I will say find a comfortable/relaxing/special place – if you struggle to identify a place as a safe place) to unwind and soothe yourself in: wrap yourself in a blanket, hold a pillow or a stuffed animal (whatever feels comfortable to you), lie down on your bed or in a closet or in a bath; take a nap.                        [e] Feel the fear in your body without reacting to it. Fear is just an energy in your body. It cannot hurt you if you do not run from it.

  8. Resist the Inner Critic’s Drasticizing and Catastophizing.                                                                           [a] Use Thought-stopping to halt the critic’s endless exaggerations of danger, and its constant planning to control the uncontrollable. Refuse to shame, hate or abandon yourself. Channel the anger of self-attack into saying “NO” to your critic’s unfair self-criticism.                                                [b] Use Thought-substitution & Thought-correction to replace negative thinking with a memorised list of your qualities and accomplishments.

  9. Allow yourself to grieve. Flashbacks are opportunities to release old, unexpressed feelings of fear, hurt, and abandonment. Validate and soothe your (inner) child’s past experience of helplessness and hopelessness. Healthy grieving can turn your tears into self-compassion and your anger into self-protection.

  10. Cultivate safe relationships and seek support. Take time alone when you need it, but don’t let shame isolate you. Feeling shame doesn’t mean you are shameful. Educate intimates (the people you are close to/you trust) about flashbacks and ask them to help you talk and feel your way through them.

  11. Learn to identify the type of triggers that lead to flashbacks. Avoid unsafe people, places, activities and triggering mental processes. Practice preventive maintenance with these steps when triggering situations are unavoidable.

  12. Figure out what you are flashing back to. Flashbacks are opportunities to discover, validate and heal from your wounds from past abuse and abandonment. They also point to your still unmet developmental needs and can provide you with motivation to get them met.

  13.  Be patient with a slow recovery process. It takes time in the present to become de-adrenalized, and considerable time in the future to gradually decrease the intensity, duration and frequency of flashbacks. Real recovery is  a gradually progressive process [often two steps forward, one step back], not an attained salvation fantasy. Don’t beat yourself up for having flashbacks.

 

I will update this next on Tuesday 17th March 2020.

©2020 Sharmi Gowri-Kriszyk Stepping Stones Psychology. All Rights Reserved